Functional and Radiological Results of the Subvastus Versus Medial Parapatellar Method in Total Knee Arthroplasty: A Randomized Controlled Cohort.
- 1Department of Orthopaedics, Apex Super Speciality Hospital and Post Graduate Institute, Varanasi, Uttar Pradesh, India.
Abstract
The subvastus method preserves the quadriceps mechanism and may facilitate earlier recovery for total knee arthroplasty (TKA). This current trial evaluated functional, pain, and radiological outcomes between the subvastus and medial parapatellar methods. This randomized controlled trial included 100 patients with primary or secondary osteoarthritis who underwent TKA at a major medical center in India between July 2023 and September 2025. Patients were randomly allocated to either the subvastus method (n = 50) or the medial parapatellar method (n = 50). Pain was evaluated using the Visual Analog Scale (VAS), whereas functional recovery was measured based on range of motion (ROM) and Knee Society Scores (KSS). Radiological outcomes included component alignment and hip-knee-ankle (HKA) angle. Patients were followed for 6 months. The subvastus group displayed substantially lower post-operative VAS scores during the first 3 days. ROM was significantly greater with the subvastus method at 2 weeks (82.56° ± 9.11° vs. 78.02° ± 7.33°; P = 0.007) and 6 weeks (98.14° ± 10.38° vs. 92.86° ± 5.20°; P = 0.002) but became comparable at 3 months. KSS improved progressively in both groups, with no significant difference at 6 months. Coronal and sagittal component alignment and HKA angles were comparable between groups. Post-operative complications were infrequent and similar between methods. The subvastus method was associated with improved early post-operative pain relief and ROM in comparison with the medial parapatellar method, whereas functional and radiological outcomes were comparable at later follow-up. These findings suggest that preservation of the extensor mechanism with the subvastus method may facilitate early post-operative recovery following TKA.
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BibTeX
@article{solanki2026functional,
title = {{Functional and Radiological Results of the Subvastus Versus Medial Parapatellar Method in Total Knee Arthroplasty: A Randomized Controlled Cohort.}},
author = {Jayvirsinh Solanki and Mukesh Yadav and Amit Kumar Jha and Swaroop Patel and S K Singh},
journal = {Journal of orthopaedic case reports},
year = {2026},
month = nov,
doi = {10.13107/jocr.2026.v16.i11.8524},
url = {https://europepmc.org/article/MED/42997192},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Functional and Radiological Results of the Subvastus Versus Medial Parapatellar Method in Total Knee Arthroplasty: A Randomized Controlled Cohort.
AU - Jayvirsinh Solanki
AU - Mukesh Yadav
AU - Amit Kumar Jha
AU - Swaroop Patel
AU - S K Singh
PY - 2026
DA - 2026/11/01
JO - Journal of orthopaedic case reports
DO - 10.13107/jocr.2026.v16.i11.8524
UR - https://europepmc.org/article/MED/42997192
AB - The subvastus method preserves the quadriceps mechanism and may facilitate earlier recovery for total knee arthroplasty (TKA). This current trial evaluated functional, pain, and radiological outcomes between the subvastus and medial parapatellar methods. This randomized controlled trial included 100 patients with primary or secondary osteoarthritis who underwent TKA at a major medical center in India between July 2023 and September 2025. Patients were randomly allocated to either the subvastus method (n = 50) or the medial parapatellar method (n = 50). Pain was evaluated using the Visual Analog Scale (VAS), whereas functional recovery was measured based on range of motion (ROM) and Knee Society Scores (KSS). Radiological outcomes included component alignment and hip-knee-ankle (HKA) angle. Patients were followed for 6 months. The subvastus group displayed substantially lower post-operative VAS scores during the first 3 days. ROM was significantly greater with the subvastus method at 2 weeks (82.56° ± 9.11° vs. 78.02° ± 7.33°; P = 0.007) and 6 weeks (98.14° ± 10.38° vs. 92.86° ± 5.20°; P = 0.002) but became comparable at 3 months. KSS improved progressively in both groups, with no significant difference at 6 months. Coronal and sagittal component alignment and HKA angles were comparable between groups. Post-operative complications were infrequent and similar between methods. The subvastus method was associated with improved early post-operative pain relief and ROM in comparison with the medial parapatellar method, whereas functional and radiological outcomes were comparable at later follow-up. These findings suggest that preservation of the extensor mechanism with the subvastus method may facilitate early post-operative recovery following TKA.
SN - 2250-0685
SN - 2321-3817
ER -